TY - JOUR
T1 - Actigraphy to Measure Physical Activity in the Intensive Care Unit
T2 - A Systematic Review
AU - Schwab, Kristin E.
AU - To, An Q.
AU - Chang, Jennifer
AU - Ronish, Bonnie
AU - Needham, Dale M.
AU - Martin, Jennifer L.
AU - Kamdar, Biren B.
N1 - Funding Information:
The authors wish to thank Bethany Myers and Carrie Price for their assistance with the literature search, as well as Sne Kanji for help in obtaining article text files. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: During this project, B.B.K. was supported by a grant through the UCLA Clinical Translational Research Institute (CTSI) and the National Institutes of Health/National Center for Advancing Translational Sciences (UL1TR000124); he is currently supported by a Paul B. Beeson Career Development Award through the National Institutes of Health/National Institute on Aging (K76 AG059936). Dr. Martin is supported by NIH/NHLBI K24 HL143055.
Publisher Copyright:
© The Author(s) 2019.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.
AB - Objective: In the intensive care unit (ICU), prolonged inactivity is common, increasing patients’ risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting. Data Sources: We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016. Study Selection: Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients. Data Extraction: Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts. Results: Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay. Conclusion: Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.
KW - accelerometry
KW - actigraphy
KW - critical care
KW - intensive care units
KW - physical activity
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U2 - 10.1177/0885066619863654
DO - 10.1177/0885066619863654
M3 - Article
C2 - 31331220
AN - SCOPUS:85070261118
SN - 0885-0666
VL - 35
SP - 1323
EP - 1331
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 11
ER -